Ectopic pregnancy

What Is Ectopic Pregnancy?

Ectopic pregnancies occur when a fertilized egg fails to attach to the uterus. In most ectopic pregnancies, the egg will attach to the fallopian tubes. Less common, it may also attach to the abdominal cavity or cervix. Ectopic pregnancies occur in one out of every 50 pregnancies.

Outside the uterus, a fertilized egg has virtually no chance of survival. This condition may cause serious health complications if not treated. As such, immediate treatment is highly recommended. Early treatment may prevent fertility problems as well as future health complications.

What Causes Ectopic Pregnancy?

The cause of an ectopic pregnancy is not clear in all cases. In some cases, the following conditions have been linked with the abnormal pregnancy:

inflammation and scarring of the fallopian tubes from a previous medical condition or surgery

hormonal factors

genetic abnormalities

birth defects

medical conditions that affect the shape and condition of the fallopian tubes and reproductive organs

Who Is at Risk for Ectopic Pregnancy?

All sexually active women are at some risk for an ectopic pregnancy. Risk factors increase with any of the following conditions:

advanced maternal age of 35 years or older

history of pelvic surgery, abdominal surgery, or multiple abortions

history of pelvic inflammatory disease

history of endometriosis

conception occurred despite tubal ligation or IUD

conception aided by fertility drugs or procedures

smoking

previous ectopic pregnancies

history of sexually transmitted diseases

What Are the Symptoms of Ectopic Pregnancy?

Nausea and sore breasts, which are also common in a normal pregnancy, are common in ectopic pregnancies. Other symptoms more clearly point to an abnormal pregnancy. The following symptoms should be discussed with your doctor:

sharp waves of pain in the abdomen, pelvis, shoulder, or neck

light to heavy vaginal spotting or bleeding

dizziness or fainting

rectal pressure

Diagnosing Ectopic Pregnancy

If you suspect an ectopic pregnancy, see your healthcare provider as soon as possible. Ectopic pregnancies cannot be diagnosed from the outside. Your doctor may perform a physical exam to rule out other factors.

If an ectopic pregnancy is suspected, a blood test can assess hCG and progesterone levels. If hormone levels are not typical, additional tests will be required.

If blood tests point to a problem, your doctor will perform a transvaginal ultrasound. This will locate the fertilized egg and confirm an ectopic pregnancy diagnosis.

In extreme cases, the fallopian tube may rupture and bleed. A surgeon may then perform an emergency laparotomy by making an incision in the abdomen. This procedure is used not only to diagnose an ectopic pregnancy, but to provide immediate treatment.

Treating Ectopic Pregnancy

Ectopic pregnancies cannot develop to term. The embryo, therefore, must be removed as soon as possible. This is necessary to both save the mother’s life and preserve her fertility. Treatment options vary depending on the location of the ectopic pregnancy and its development.